The recent tragedy in which 45 passengers were charred to death after their bus crashed on the Bangalore-Hyderabad highway has once again turned the spotlight on the appalling state of road safety in India.
The country has the worst road traffic accident rate in the world, with more people dying in road mishaps in India every year than anywhere else, including China.
The statistics are chilling. In 2011, there were 4.98 lakh road accidents in India which killed 1.42 lakh people and injured 5 lakh more.
These numbers translate into a road accident every minute and one road accident death every four minutes. The situation is actually worse since many accidents never get reported. As the number of vehicles goes up on the roads, the fatalities also increase with each passing year.
Dangerous cocktail
Road accidents have a much higher impact than assumed. Not only is the family of the victim devastated emotionally and financially, there is also socio-economic penalty in terms of loss of productivity, over-burdened hospitals, rising healthcare expenditure and insurance claims, and wrecked vehicles.
Injuries in road accidents are often severe enough to turn people into life-long cripples. In head-on collisions, the initial impact point is often the lower parts of the body, resulting in fracture or dislocation of ankles, knees, hips and thigh bones.
A sideways impact usually involves damage to the upper parts of the body including injuries to the chest, diaphragm, abdominal organs and pelvis.
Experts have identified some major risk factors in road accidents such as drunken driving, over-speeding, and not using protective gear such as motorcycle helmets, seat-belts and child restraints.
In India, there is another unique factor: busy roads that lack central dividers and are too narrow for the traffic they carry. Out of the 71,000 km of national highways in the country, about 50,000 km are two-lane roads!
The presence of traffic police is thin on the ground, drivers, especially of trucks, hardly get any training, the system to get driving licences is lax, and traffic laws are broken with impunity. All this makes for a dangerous cocktail for road safety. Though the use of crash protection devices such as helmets, seat belts and air bags has increased over the years, injuries due to road traffic-related trauma are worsening each year.
India needs comprehensive road safety laws and an international-standard road network to drastically reduce the incidence of fatal accidents.
Simpler rules now
There is another critical aspect to saving lives: providing medical attention to accident victims in the shortest time possible so that they don’t die on the spot. This is easier said than done, as various enforcement agencies are involved, each following different parameters.
The first hour after an accident is called the “golden hour” because doctors believe that more than half of all deaths on roads can be prevented if the victims are rushed to a hospital within sixty minutes. However, according to one estimate, only 20 per cent of accident victims in India are provided medical care in the first hour. A huge chunk of the rest succumbs to injuries. Well-intentioned bystanders, unaware of the basics of first-aid, often cause more damage to the injured.
Well-equipped pre-hospital trauma centres and efficient emergency services providing emergency medical treatment (EMT) are the need of the hour to reduce the rising number of preventable deaths after a traumatic injury.
The optimal care of accident victims requires a coordinated approach from the point of injury to transfer to a hospital facility.
The National Highways Authority of India (NHAI) has made 24x7 ambulance and patrolling services mandatory on national highways.
Highway developers are required to deploy one ambulance and one patrolling vehicle for every 50 km stretch of asphalt. However, only a small fraction of the national highway network has been covered by this arrangement.
Regardless of how sophisticated the trauma centres are, perhaps the most important role in saving lives is performed by bystanders who call for help and provide assistance until the ambulance arrives.
In India, most people shy away from assisting the victims fearing legal complications, court appearances and police questioning.
Even though regulations now do not require hospitals or the police to record the details of the person accompanying the injured, earlier forms still continue in circulation without any change.
We have to widely publicise this fact to encourage more people to get involved in saving accident victims. India needs an enabling legal environment to protect do-gooders from regulatory hassles and adverse consequences. There are rules for this but even the Government agencies do not follow them.
Urgent attention
Compilation of data about road accidents is faulty and does not give the right picture. Badly engineered roads and weather are not included among accident causes of accidents.
Factors such as tyre bursts and weather are not considered at all or attributed to driver’s fault. India needs a better data management system of global standards.
To reduce the number of road accidents, India requires improved roads, safer and better vehicles, strict implementation of traffic rules, especially for drunken driving, wearing helmets, not talking on the mobile phone while driving, and prompt medical care for the victims.
We are facing a full-blown national calamity on our roads that demands urgent attention of the government.
(The author is an orthopaedist)